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10 <br />11. <br />OR <br />12. <br />5-20 gallon container v/ilh spigot) <br />•M. <br />[ <br />rii-L"|ii < l <br />>f6r <br />L;rl/i7on;iio;)uil Hg.'iIHi J’ <br />M III I. . . <br /> Ill I <br />w.- <br />SAN JOAQUIN <br />< < >1 IM I Y <br />I r <f<.i».-ii j‘ i ■> <br />| i Ihl ■ !•' > f't’ ll • '<H <br />HIM | H;i/<.||«jn AvcihioI SIoiMoii, C.ilifoinia 952()f> | I 2094603420| I '.'09 4G4 0138 | wr.w sjcchd ran <br />tun ii w l-.U'. ii-l i' it urivi Mi .-•■i- <br />•■liiipoilanl" All food vendr; <br />/ preparntjeri' <br />/ prepaH)\on <br />I tliia’e/anK <br />Completed by <br />; imp i i | <br />I am pioviding the. following items wilhin my booth lor llm sanllaiy cleaning of food preparation u?u>..'l <br />I | Thiee compartment sink. <br /> Three deep tubs (basins 6-8 inches minimum), one lor soapy v/atei. one for nnsing and one for a b’ id. <br />solution (one tablespoon of bleach per gallon ofwatei) <br /> Detergent, bleach and wiping cloths (cleaning towel';) <br />O Tub to store wiping cloths in l)leach solution. <br />I am providing the following lor adequate hand washing facilities, but separate from utensil wash within m/ <br />booth. <br />J/J Waler supply dispenser will) warm water at a minimum of 100' F (i e <br />^0 One separate tub (bucket or basin) lor the collection of nnse/waslewater. <br />J2 Paper towels and pump-stylo soap container <br />13. Names of responsible persons Io bo present in booth during all hours of operation <br />(Will-) QjA ___________________ ____________ <br />fl <br />Ice Cooler | | <br />| I lealth PermH <br />I am pnwidinq the following cold (omperaliim conlrol for Hu.' cold lidding of potentially Imzanfou. ! - I- o-;! ,.' <br />15'1 (if food is used the following d iy, mainlain bolowd I F temperature) <br />LI Ice chests Rciiigoraloi <br />| J Refngcialed hurl: |'_ I Ice hath arid tubs <br />I-] Other (specify)_______________________________________________________ <br />.__A <br />I . lV,1 ■ .1 :JI.. IV. • . <br />J3, <br />jths are subject to inspection. Please make a cony of this applicalioti in <br />'foTlhmevenl. A copy of this checklist must be in the booth at all houis of <br />and opdralion Return oiiginal to festival coordin itor three weeks prior to <br /> <br />Title <br />VjoI&o I <br />r>th | | <br /> Ui<0111 ini' >11 j on <br />Colli It tr, A .p'l.ltl, <br />I’lyw-eit, ci a "I.up